Vaccine programme works to rid world of polio forever

It is shocking to know that only two diseases in the world have actually been eradicated, Cathy Owen looks at what is being done worldwide to combat illnesses to improve the world’s health in the future

Illnesses and deaths from most vaccine-preventable diseases targeted since 1980 have declined by 80% or more because of widespread vaccination – but only smallpox and the little known animal disease rinderpest have been successfully wiped out.

Vaccinations have been a key contributor to the decrease of child deaths and the increase of life expectancy during the past century, but getting rid of the diseases completely is proving more difficult.

Virologist Dr Julia Reg-Noves, a senior lecturer at Cardiff Metropolitan University’s School of Health Sciences, admitted that not as many diseases had been eradicated as had been hoped.

“There have been many plans for eradication but often you find that the goal posts have to be moved,” she explained. “It was thought that polio had been beaten and then there is another outbreak somewhere in the world.

“But there are good vaccines out there that we hope will succeed, a lot of the time though money is the problem.”

Concerns about the cost of these vaccination programmes are often raised, but those objections are wiped out by how much money not having to treat these conditions will save, for example the eradication of polio will save $50m by 2035.

Dr Thomas Friedman, director for the Centre for Disease Control and Prevention, said: “Although it may be expensive to carry out these vaccine programmes, it is not as expensive to vaccinate as it would be to deal with the costs of treating these diseases.”

A baby is given a dose of oral polio vaccine

But while vaccination has brought many diseases under control, smallpox and rinderpest are the only two to have been eradicated, while guinea worm and polio are both close to being wiped out.

Recently, India was declared polio free after a major vaccination programme which saw public health workers chasing down buses on their motorcycles in order to reach every child.

Before vaccination, there were approximately 350,000 cases per year globally. The global effort, which began in 1988 by the World Health Organisation, Unicef and the Rotary Foundation, has reduced the number of annual diagnosed cases from those hundreds of thousands figures to 291 in 2012 – a 99.9% reduction.

They are hoping for the same success as with smallpox.

The first vaccine for it was discovered by British physician Edward Jenner who discovered the effectiveness of cowpox to protect humans from smallpox in 1796, but the British government didn’t introduce compulsory smallpox vaccination until 1853, when it was made an Act of Parliament.

By 1900, the disease had effectively been eliminated in northern Europe, three years after America, and by 1914, the incidence in most industrialised countries in the world had decreased to comparatively low levels.

After vaccination campaigns, the World Health Organisation (WHO) confirmed the eradication of smallpox in 1980.

Dr Margaret Chan, of the WHO, said an achievement of this scale ultimately depended on tens of thousands of dedicated workers who literally criss-crossed this entire globe, by jeep, donkey, fishing boats, on foot in jungle and desert journeys, from nomadic tribes in remote mountain areas to permanent dwellers in the scorching heat of Asia’s slums.

But as Dr Reg-Noves points out, that with eradication and big projects like this success hinges on the enormous funds needed to finance the next steps.

“A lot of the time it is about the money and the huge cost of funding these programmes of eradication,” she explained.

“Billionaires like Bill Gates help a lot, but there is so much more money needed. There are also concerns about new and emerging conditions like HIV, a virus we started dealing with in the 1980s. Back then it was hoped that there would be a some sort of fantastic vaccine within five to 10 years, but it is a much cleverer virus than us and there are so many mutations that we still don’t have a vaccine.

“Influenza is also a big problem and different forms have emerged from Mexico and in China. Viruses are always challenging because they are always changing and adapting. But it is getting very close with polio and the work will always continue.”

As Dr Chan said: “The international community has very few opportunities to improve this world in a permanent way. Polio eradication is one such opportunity. Ridding the world of the poliovirus will be a perpetual gift to every future generation of children.”

Rotary is also working on eradicating polio, and hopes that it could be on the brink of making history.

International End Polio Now coordinator and Cardiff Bay Rotary member Mike Parry said: “When eradicated, polio will be only the second disease in human history to be eradicated following the spectacular success of ridding the world of smallpox in 1979.

“After nearly 30 years, and after immunising more than two billion children against polio, the world’s largest voluntary service organisation, Rotary International, and its partners are on the brink of making history.

“When Rotary began the fight in 1985, polio affected 350,000 people, mostly children, in 125 countries every year. Since then, polio has been reduced by more than 99%.

“Fewer than 700 new cases were reported in 2011, and the wild poliovirus today is confined to isolated pockets in only three countries. But if they don’t finish the fight right now, polio could quickly re-surge, with devastating consequences.

“More than 10 million children could be paralysed in the next 40 years. This once-in-a-generation opportunity would be gone forever.

“Polio is one of only a few diseases which can be completely eradicated, such as was the case with smallpox.

“By eradicating polio, children across the entire world will benefit and no child need ever know the pain of polio-paralysis.

“The director general of the World Health Organisation has described the current state of polio eradication as being at a tipping point between success and failure.

“A Global Emergency Action Plan has been developed to address the critical programmatic risks and source the urgent additional investment that is essential to tip it towards success.”